Universal neonatal auditory screening programs have expanded greatly because of improved auditory measurement capability, improved rehabilitation strategies, and changes in governmental policies including the passage of laws in 38 states and in an increasing number countries internationally. An improvement in screening program performance has the potential of positively affecting 4 million neonates born in the United States annually and a much larger number internationally. The current NIH consensus statement acknowledged that a majority of personnel performing screening tests will be nursery staff with minimal or no experience with auditory measures and therefore require substantial training. The rate of incorrect refer results has been unacceptably large because of measurement errors due to a variety of factors including personnel training. Our long term goal is to develop measurement and calibration devices that can reduce these errors thus having a positive impact on all neonates. [unreadable] [unreadable] An innovative neonatal simulator is proposed that can be used for training purposes, for determining the adequacy of a screening device on site, for research purposes, and for inclusion in documents by standards groups. The simulator will consist of a life-sized synthetic neonate with physical, acoustic and electrical characteristics that simulate those of normal and hearing-impaired neonates and that will cause any conventional screening device to operate as designed. The availability of such a device will improve any neonatal hearing screening program by providing a mechanism for improving training of operators and by verifying that the screening device is operating properly at the time of a refer screening result. The device also can be adapted for calibration and for incorporation in upcoming standards documents. [unreadable] [unreadable]